Postpartum in the First Week: What to Expect, What’s Normal, and How to Care for Yourself
The first week after birth is a whirlwind. Your body is healing, your hormones are changing, your milk may be coming in, and you’re getting to know your baby. This guide offers evidence-based, practical steps to help you feel more confident in the first seven days. It’s not a replacement for medical care—use it alongside your healthcare team’s advice and don’t hesitate to call them with concerns.
Big Picture: The First Seven Days
In the first week, vaginal bleeding (lochia) is heaviest and bright red at first, cramping and soreness are common, and fatigue is expected. If you’re breastfeeding, your milk typically transitions from colostrum to mature milk around days 2–5. Emotionally, many parents experience “baby blues” around days 3–5, with mood swings, tearfulness, and overwhelm that usually improve by week two. If you’ve had a cesarean birth, add incision care and activity limits to your recovery plan. It’s a lot—but with rest, support, and small daily routines, most people notice steady improvement each day.
Vaginal Bleeding and Uterine Cramps (Afterpains)
Bleeding is usually like a heavy period at first, then tapers to pink or brown. You may pass small clots, especially after resting; breastfeeding can trigger cramps as the uterus tightens, which is normal. Use pads (not tampons) until your provider says they’re safe, typically after your 6-week check. Call your healthcare provider urgently if you soak a pad in an hour or less, pass clots larger than a golf ball, feel dizzy or faint, or your bleeding suddenly increases after slowing—these can be signs of postpartum hemorrhage and need prompt attention (ACOG).
Perineal Care (Vaginal Birth) and Hemorrhoids
If you have stitches or perineal soreness, cool packs in the first 24 hours can help, followed by warm sitz baths (or a peri bottle with warm water) a few times daily. Pat dry, change pads frequently, and keep the area clean. For hemorrhoids, gentle cleansing, witch hazel pads, and avoiding straining can help. Talk with your provider about using a stool softener if needed.
Step-by-step perineal care: 1) After each bathroom trip, rinse with warm water using a peri bottle. 2) Pat dry front to back with soft tissue or a clean cloth. 3) Apply a new pad; consider a cool pack for 10–15 minutes. 4) Do gentle pelvic floor contractions (if comfortable) a few times a day to support circulation and healing.
Cesarean Incision Care
Keep the incision clean and dry. You can usually shower and let soapy water run over the area; pat dry—no scrubbing. Wear loose, high-waisted clothing and support the incision with a pillow when coughing or laughing. Avoid heavy lifting (nothing heavier than your baby) and driving until your provider clears you. Call if you notice increasing redness, swelling, warmth, pus-like drainage, separation of the incision, fever of 100.4°F/38°C or higher, or worsening pain.
Pain Management
It’s okay to need pain relief. Nonsteroidal anti-inflammatory medications like ibuprofen and acetaminophen are typically first-line and considered compatible with breastfeeding; take them as directed by your clinician and the product label. Heat packs often help with uterine cramps; cold packs can reduce perineal swelling in the first 24 hours. If you were prescribed stronger medication, use only as directed and store it safely. Always ask your provider or pharmacist about any medication while breastfeeding (ACOG).
Breastfeeding and Milk Coming In
Early, frequent feeding helps your milk come in and protects supply. Aim for 8–12 feeds in 24 hours, responding to early hunger cues (stirring, rooting, hand-to-mouth). Most babies lose a little weight in the first days; your baby’s pediatrician will track weight and output to ensure feeding is going well.
Tips for a comfortable latch: 1) Bring baby to you, tummy-to-tummy, nose opposite your nipple. 2) Tickle the top lip with your nipple and wait for a wide-open mouth. 3) Bring baby in quickly so the chin and lower lip lead; you should feel tugging, not pinching. 4) If it hurts, break the seal gently with a clean finger, reposition, and try again. 5) Offer both sides; let baby finish the first side before switching.
Engorgement (days 2–5) shows up as very full, firm breasts. Before latching, soften the areola with a few minutes of hand expression or brief pumping, and warm compresses. After feeds, use cool compresses for 10–15 minutes. If you’re uncomfortably full and baby can’t feed, express just enough for comfort. If you develop fever, flu-like aches, and a red, painful area of the breast, call your provider—these can be signs of mastitis (CDC).
If you are formula feeding, feed on cue (usually every 2–4 hours), prepare formula exactly as directed, and discard unused formula within safe time windows. Hold baby upright and paced-feed to avoid overfeeding. Always mix formula with water as directed—never concentrate powder to “top up” calories (CDC/AAP).
Hydration, Nutrition, and Bowel/Bladder Care
Keep a water bottle within reach and drink to thirst—breastfeeding parents may need more fluids. Aim for balanced meals and snacks with protein, fiber, and healthy fats. Constipation is common; prioritize fluids, fiber-rich foods (fruits, vegetables, whole grains), and gentle walking. If needed, ask about stool softeners. To urinate comfortably after vaginal birth, try running warm water over the perineum with your peri bottle as you void. If you have pain or can’t urinate, call your provider.
Rest and Activity
Short, frequent rests help recovery. Think “rest when the baby rests” and delegate nonessential tasks. Gentle movement like short hallway walks supports circulation and mood; avoid high-intensity exercise, heavy lifting, or core workouts until your clinician clears you. Pelvic floor contractions (Kegels) can begin when comfortable. If you feel increased bleeding, pain, or dizziness, you may be doing too much—scale back.
Mood: Baby Blues vs. Postpartum Depression
It’s normal to feel weepy, overwhelmed, or anxious in the first week (the “baby blues”). These feelings usually improve by the end of week two. If sadness, anxiety, irritability, or hopelessness are intense, persist beyond two weeks, or you have scary thoughts (like harming yourself or the baby), contact your provider right away—postpartum depression and anxiety are common and treatable. If you have thoughts of self-harm or harming your baby, seek emergency help immediately (NIMH).
Contraception and Sexual Activity
Ovulation can return before your first period, even if you’re breastfeeding. Discuss contraception early—some methods can be started immediately postpartum. Most people wait to resume vaginal intercourse until bleeding has stopped and discomfort has improved, typically after a clinician’s clearance at follow-up. Choose a method that fits your goals and feeding plans; progestin-only options are often compatible with breastfeeding (ACOG/WHO).
Red-Flag Symptoms: Call for Help
Contact your healthcare provider urgently or seek emergency care if you have any of the following: 1) Heavy bleeding (soaking a pad in an hour or less or passing large clots), dizziness, or fainting. 2) Fever of 100.4°F/38°C or higher, chills, or foul-smelling discharge. 3) Severe headache, vision changes, shortness of breath, chest pain, or swelling and pain in one leg—these can indicate postpartum preeclampsia or blood clots. 4) Worsening abdominal or incision pain, redness, pus, or wound separation. 5) Signs of breast infection (fever plus a painful, red area) or inability to keep fluids down. Trust your instincts—if something feels off, call.
A Simple Day-One-to-Seven Plan
Day 1–2: Focus on rest, skin-to-skin time, and frequent feeds. Manage pain with scheduled medications as directed. Learn perineal/incision care. Ask for a lactation consult before leaving the hospital if you are breastfeeding.
Day 3–4: Expect emotional ups and downs and milk coming in. Use warm compresses before feeding and cool packs after for breast comfort. Start short walks. Confirm pediatric and postpartum follow-up appointments.
Day 5–7: Bleeding should be lighter than the first days. Keep feeding on cue. Fine-tune latch or bottle technique. Continue gentle pelvic floor work and sitz baths if helpful. Review contraception options with your provider if you haven’t already.
Build Your Support Team
Ask a partner, friend, or family member to take on meals, laundry, and errands. Post a simple list on the fridge: how you like your tea, where diapers are, your preferred snacks. Consider lining up a lactation consultant, a postpartum doula, or a local/new-parent support group. Virtual visits can be helpful if in-person isn’t possible.
Follow-Up Care: Don’t Wait for Six Weeks
Modern guidelines encourage earlier contact. Your obstetric provider should check in within the first 1–3 weeks and see you for a comprehensive visit by 12 weeks; reach out sooner for any concerns. Most babies are seen by their pediatrician at 3–5 days after birth to assess feeding, weight, and jaundice (ACOG/AAP).
Quick Reminders
Wash your hands before feeding and after diaper changes. Keep showers short and avoid soaking baths until cleared if you have an incision or stitches. Avoid tampons and douching. If you had high blood pressure during pregnancy, monitor at home if advised and report readings or symptoms promptly. Keep emergency numbers handy.
You’re Doing Better Than You Think
This week is about healing and connecting with your baby. Progress can feel uneven—two steps forward, one step back is normal. Celebrate small wins: a comfortable latch, an extra hour of sleep, a warm meal. Accept help, be gentle with yourself, and lean on your care team. You’ve done something extraordinary, and you deserve excellent care.
References and Helpful Resources
American College of Obstetricians and Gynecologists (ACOG). Optimizing Postpartum Care. Committee Opinion No. 736. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care
ACOG. Postpartum Pain Management. Patient FAQ. https://www.acog.org/womens-health/faqs/postpartum-pain-management
World Health Organization (WHO). WHO recommendations on maternal and newborn care for a positive postnatal experience (2022). https://www.who.int/publications/i/item/9789240045989
Centers for Disease Control and Prevention (CDC). Breastfeeding: Common Conditions (engorgement/mastitis). https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/index.html
CDC. Infant Formula Preparation and Storage. https://www.cdc.gov/nutrition/infantandtoddlernutrition/formula-feeding/preparation-and-storage.html
National Institute of Mental Health (NIMH). Perinatal Depression. https://www.nimh.nih.gov/health/publications/perinatal-depression
American Academy of Pediatrics (AAP). First Office Visit, 3–5 Days. https://www.aap.org/en/patient-care/newborn-and-infant-nutrition/newborn-and-infant-health-assessment-and-promotion/first-office-visit-3-5-days/
ACOG. Postpartum Preeclampsia. https://www.acog.org/womens-health/faqs/preeclampsia-and-high-blood-pressure-during-pregnancy
ACOG. Postpartum Birth Control. https://www.acog.org/womens-health/faqs/postpartum-birth-control